15080101CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10355 N DE ANZA BLVD
CONTRACTOR: STATEWIDE ROOFING
PERMIT NO: 15080101
INC
OWNER'S NAME: VIDOVICH- CUPERTINO LIMITED PARTNERS
5542 MONTEREY RD
DATE ISSUED: 08/13/2015
OWNER'S PHONE: 4089749575
SAN JOSE, CA 95138
PHONE NO: (408)288 -8680
IkI LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
LAY OVER (E) B.U.R. & APPLY (N) .60 MIL T.P.O.
License Class G'/ Cf Lic. # P/a ?� Q �-�
ROOFING SYSTEM (219 SQ'S)
/
Contractor S� 1CV Jw fi0/7K ate (194 l3 C)15
I hereby affirm that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self - insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
Sq. Ft Floor Area:
Valuation: $125000
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
APN Number: 32633113.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
I INSPEC ION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will co
ue b Date:
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature to US71 % /2
RE- ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant: e: LaJ 13 1
9
❑ OWNER- BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
�RR
the following two reasons:
ALL ROOF COVERINGS TO BE A " OR BETTER
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self - insure for Worker's
material. Additionally, should I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 25505, 25533=2n25534 .
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: ate• !/ W44
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked.
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
ARCHITECT'S DECLARATION
costs, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date
CUPERTINO
REROOF PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(408) 777 -3228 • FAX (408) 777 -3333 • building(ftupertino.org
/
PROJECT ADDRESS �55, N. De Anza Blvd. _7N"
Jl3
OWNERNAME II do V Pc. .CVp
Apple, Inc ' �� �.
PHONE 408 974 -9575
( )
E -MAIL
STREET ADDRE�� e ,Q
�C� � Sun
CITY, ST "rr oro 1°� CA _ _ 4 tlC>2
cas
FAX
CONTACT NAME
Michael Courtney
PHONE
408 - 286 -7828
E -MAIL
mcourtney @swroof.net
STREET ADDRESS 5542 Monterey Road, #201
CITY, STATE, ZIP San Jose, CA 95138
FAX 408- 286 -7820
❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT IX CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Michael Courtney
LICENSE NUMBER 803926
LICENSE TYPE C39
BUS. LIC.# 23509
COMPANY NAME Statewide Roofing, Inc.
E -MAIL mbotill @swroof.net
FAX 408 - 286 -7820
STREET ADDRESS 5542 Monterey Road, #201
CITY, STATE, ZIP San Jose, CA 95138
PHONE 408 - 286 -7828
ARCHITECT/ENG VEER NAME
LICENSE NUMBER
BUS. LIC. #
COMPANY NAME
E -MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or Duplex ❑ Multi - Family
STRUCTURE: C Commercial
ROOF AREA:
21,900 sf
VALUATION:
$125,000
EXISTING ROOF TYPE: IR BUILT -UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER (SPECIFY)
REMOVE /REPLACE ❑ YES
® NO
IF NO,
#LAYERS: 1
PLYWOOD ❑ h" ❑
THICKNESS: ❑ 518"
PLYWD ❑ OSB
TYPE: ❑ CDX
PITCH:
25 :12
ROOF
1 CLASS: A
PROPOSED ROOF TYPE: ❑ BUILT -UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES N OTHER •60 mil TP
[CC-ES REPORT #
DESCRIPTION OF WORK:
Clean and prepare existing roof and overlay with .60 mil TPO roofing system.
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's be . I have read this
application and the information I have provided i correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to b c I authorize representatives of Cupertino to enter the above - identified property for inspection purposes.
Signature of Applicant/Agent: Date: 8/13/15
SUPPLEMENTAL INFO ATION REQUIRED
_ If building is associated with a Home Owner's Association, provide letter
of approval from HOA.
Provide Planning approval to verify if there any restrictions.
Provide copy of Manufacturers Installation Specifications.
Provide signed copy of Cupertino's Tear -Off Policy.
OFFICE USE ONLY
PLAN CHECK TYPE
ROUTING SLIP
R- THE - COUNTER
❑ EXPRESS
❑ STANDARD
❑ BUILDING PLAN REVIEW
❑ PLANNING PLAN REVIEW
❑ EIRE DEPT
❑ OTHER:
ReroofApp_201 1. doc revised 03116111
�� CITY OF CUPERTINO
I�JSiI FEE ESTIMATOR — BUILDING DIVISION
FEE ID ROOF AREA
s.f.
1REROOFCOM 21,900
: ow, " ' — c ?m p
. '
,Mech. Plan Check Plumb. flan Check Elec. 1'ian C.`hec?
Fllech Permit Fee' Plumb. Permit Fee: flee Permit Fee:
tither : /cch. Insp. 01her Plumb Imp. tither Oec. Insp.
A, /ech. Insp. Fee: Phimb. hash. hee: Elec. lnsp. lee:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
Metrirt_ otr_ )_ Thoco foot Oro hacod an tho nroliminary infarmatian availahlo and Oro anhr an octimato_ Contort tho Dont far addn'1 info_
FEE ITEMS (Fee Resolution 11 -053 E . 711113)
10355 N DE ANZA BLVD
DATE: 08/13/2015
REVIEWED BY: MELISSA
IlaADDRESS:
APN: 326 33 113
BP #:
*VALUATION: 1$125,000
*PERMIT TYPE: Minor Building Permit
PLAN CHECK TYPE: Re -roof
PRIMARY
USE: Commercial Building
1'lz�mb.L�llc:c•la.; �lc�c
PENTAMATION
PERMIT TYPE: 1 COMMLROO i
WORK
OVER E B.U.R. & APPLY (N).60 MIL T.P.O. ROOFING SYSTEM
[LAY
SCOPE
Suppl. Insr? Pee
FEE ID ROOF AREA
s.f.
1REROOFCOM 21,900
: ow, " ' — c ?m p
. '
,Mech. Plan Check Plumb. flan Check Elec. 1'ian C.`hec?
Fllech Permit Fee' Plumb. Permit Fee: flee Permit Fee:
tither : /cch. Insp. 01her Plumb Imp. tither Oec. Insp.
A, /ech. Insp. Fee: Phimb. hash. hee: Elec. lnsp. lee:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
Metrirt_ otr_ )_ Thoco foot Oro hacod an tho nroliminary infarmatian availahlo and Oro anhr an octimato_ Contort tho Dont far addn'1 info_
FEE ITEMS (Fee Resolution 11 -053 E . 711113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
SuppL Pt:' Fee
1'lz�mb.L�llc:c•la.; �lc�c
Permit Fee:
$1,647.00
Suppl. Insr? Pee
1'lzirnb.; �i�!1Gt't�.i Flee
I'lz�nth.:'11 ch. %1 lec Permit Fee:
Construction .Tax:
Achninlstrative Fee:
Work Without Permit? 0 Yes E) No
$0.00
Advanced Planning Fees:
7i°m,el Docurnentalurn Fees:
Strong Motion Fee: IBSEISMICO
$35.00
Select an Administrative Item
Bldg; Stds Commission Fee: IBCBSC
$5.00
Zn
' �,
$1,687.00
$0.00v,9 `'s, TO L FEE
$1,687.00
Revised: 07/02/2015
CUPERTINO
REROOF TEAR -OFF POLICY
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(408) 777 -3228 • FAX (408) 777 -3333 • building(afcupertino.org 156'3(0101
PROJECT ADDRESS 10355 N. De Anza Blvd.
APN a 3 Z� 3 3
OWNER NAME Apple, Inc. 10 v v ` vp
PH
E -MAIL
STREET ADDRESS !� A,.
CITY, STATE, Z1054,17$ CAA ` 7 .�
FAX
CONTRACTOR NAME Michael Courtney
LICENSE NUMBER 803926
LICENSE TYPE C39
BUS. LIC. $ 23509
COMPANY NAME Statewide Roofing, nc.
9,
E -MAIL mbotill swroof.net
@
FAX
408 - 286 -7820
STREET ADDRESS 5542 Monterey Road, #201
CITY, STATE, ZIP San Jose, CA 95138
PHONE 408- 286 -7828
I UNDERSTAND AND AGREE TO THE FOLLOWING:
1. The re -roof project shall comply with all applicable provisions of the 2010 California Codes.
2. An inspection request can be scheduled up to the day before the inspection date. Please call (408)777-
3228 from 7:30 - 3:30pm (Mon - Thurs) or 7:30 - 2:30pm (Friday) to schedule the next day inspection.
For Tear -Off and Nailing Inspections, you must also call on the day of the inspection only after that
phase of the work is completed. The building inspector will be available within one hour. Progress
and Final Inspections will be given a two hour window.
3. Tear -Off Inspection is required. Any and all dry -rotted wood shall be replaced prior to this inspection.
Unless new plywood roof sheathing is proposed throughout, all the nails /fasteners shall be either
completely knocked -down or removed prior to this inspection.
4. If plywood is installed, a plywood Nailing Inspection is required.
5. Roofing shall not be applied without first obtaining all prior inspection and written approvals from the
building inspector. Any roofing which is applied without first obtaining an approved inspection will
require the removal of all new material down to the sheathing so a proper inspection can be performed.
6. Progress Inspection is required when approximately 50% of roof covering is installed.
7. A Final Inspection and approval shall be obtained from the building inspector when the re- roofing is
completed. To receive a final sign -off, the following items will be verified:
a. Flat roofs shall have a minimum of I/" per foot of slope and demonstrate there is no ponding.
b. Listings from approved testing agencies for all pre - manufactured products used shall be
available on -site to review at the time of the inspection.
c. Proper spark arrestor installation, vents painted, gutter /downspouts installed, debris removed.
8. NOTE: If you call for a tear -off or plywood nailing inspection and the work is not complete, you will be
charged a re- inspection fee of $126.00. The re- inspection fee shall be paid before another inspection
can be scheduled.
By my signing below, I certify each of the following is true: I am the property owner or authorized agent to act on the
property owner's behalf. I understand and agree to comply with the re -roof policy stated above. I also understand that
smoke detectors and carbon monoxide det c ors a required to be installed in accordance with Sections R314 and R315 of
the 2010 California Residential Code.
Signature of Applicant /Agent: Date: 8/13/15
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